Purpose. To evaluate the incidence and risk factors of periprosthetic joint infection (PJI) in patients undergoing total knee arthroplasty (TKA) in a highvolume hospital. Methods. Records of 1133 primary TKAs were reviewed. Correlation between surgery volume and infection rate was determined. Risk factors for PJI were identified using case-control analysis of variables. TKAs performed between October 2012 and March 2013 without infection were used as controls. Results. Of 1133 TKAs, 8 (0.71%) PJI occurred. The organisms involved were Staphylococcus aureus (n=4), coagulase-negative staphylococci (n=2), Pseudomonas aeruginosa (n=1), and methicillin-resistant S aureus (n=1). In the 6-month period chosen as the control period, one (0.52%) out of 192 TKAs developed PJI. Hospital annual volume did not correlate with infection rate (p=0.766). Significant risk factors included young age, comorbidities such as diabetes,
Purpose. To compare the short-term outcome in patients with or without a drain (short duration and low suction pressure) following total knee replacement (TKR). Methods. A consecutive series of 106 women and 48 men (mean age, 69 years) underwent unilateral TKR. The first 77 patients used a low suction pressure (200 mm Hg) drain following TKR for 24 hours, and the next 77 patients used no drain. Results. The 2 groups were comparable in terms of preoperative characteristics, the proportion of patients with pharmacological prophylaxis for deep vein thrombosis, the tourniquet time, and mode of anaesthesia. The mean drain output in the drain group was 221 ml. The time to achieve straight-leg-raising was earlier in the drain group (3.1 vs. 4.2 days, p<0.001). Conclusion. The use of a short duration, low suction pressure drain following TKR enabled an earlier return of quadriceps power, without increasing haemoglobin drop and transfusion rate.
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